NPI | 1235412503 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 51673) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003678) |
363AM0700X Physician Assistant, Medical (Licence: VA 0110003678) | |
363AS0400X Physician Assistant, Surgical (Licence: VA 0110003678) | |
363AM0700X Physician Assistant, Medical (Licence: CA 51673) | |
Enumeration Date | 2011-09-23 |
Last Update Date | 2014-12-15 |