NPI | 1285763334 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110002491) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: VA 0110002491) |
Enumeration Date | 2007-03-05 |
Last Update Date | 2014-02-21 |