NPI | 1275534554 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA000456L) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA000456L) |
Enumeration Date | 2005-08-09 |
Last Update Date | 2020-10-13 |