NPI | 1285913541 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA200002153) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106083) |
363AS0400X Physician Assistant, Surgical (Licence: VA 0110007010) | |
Enumeration Date | 2011-08-04 |
Last Update Date | 2025-08-26 |