NPI | 1285396341 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: PA OA005765) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: PA OA005765) |
363AM0700X Physician Assistant Medical (Licence: PA MA062686) | |
363AS0400X Physician Assistant Surgical (Licence: PA MA062686) | |
Enumeration Date | 2021-10-06 |
Last Update Date | 2021-10-06 |