NPI | 1255579207 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 20174) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA 20174) |
Enumeration Date | 2009-01-29 |
Last Update Date | 2016-10-10 |