NPI | 1265158810 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: ID PA-2393) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2022-10-17 |
Last Update Date | 2022-11-11 |