NPI | 1245414978 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA01337) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA22873) |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2007-12-17 |
Last Update Date | 2016-05-25 |