NPI | 1316685258 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 62114) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AS0400X Physician Assistant, Surgical (Licence: CA 62114) | |
Enumeration Date | 2022-05-20 |
Last Update Date | 2023-01-20 |