NPI | 1316289481 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: HI AMD537) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL pa9106806) |
363AM0700X Physician Assistant, Medical (Licence: FL pa 9106806) | |
363AM0700X Physician Assistant, Medical (Licence: HI AMD537) | |
363AS0400X Physician Assistant, Surgical (Licence: FL pa9106806) | |
Enumeration Date | 2013-03-26 |
Last Update Date | 2023-10-16 |