NPI | 1255403770 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA15603) |
Additional Taxonomies | 174400000X Specialist (Licence: CA PA15603) |
208600000X Surgery (Licence: CA PA15603) | |
363AS0400X Physician Assistant Surgical (Licence: CA PA15603) | |
Enumeration Date | 2006-11-14 |
Last Update Date | 2023-01-10 |