NPI | 1295449767 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116843) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9116843) |
Enumeration Date | 2023-01-10 |
Last Update Date | 2024-04-09 |