NPI | 1316181480 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60200499) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA153069) |
Enumeration Date | 2009-04-20 |
Last Update Date | 2016-02-04 |