NPI | 1245882000 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61401505) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61401505) |
Enumeration Date | 2019-07-11 |
Last Update Date | 2023-11-02 |