NPI | 1336734789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61338060) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61338060) |
Enumeration Date | 2021-03-08 |
Last Update Date | 2023-10-02 |