NPI | 1245203397 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NV PA1786) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 007274) |
363AS0400X Physician Assistant, Surgical (Licence: NC 0010-03118) | |
363AS0400X Physician Assistant, Surgical (Licence: OH 50.001903) | |
Enumeration Date | 2006-02-09 |
Last Update Date | 2020-08-28 |