NPI | 1326593328 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA OA003953) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058396) |
Enumeration Date | 2016-08-19 |
Last Update Date | 2024-12-12 |