NPI | 1275619454 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA13714) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA137140) |
Enumeration Date | 2006-10-31 |
Last Update Date | 2015-07-27 |