NPI | 1346589447 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60433471) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-03989) |
363A00000X Physician Assistant (Licence: WA PA60433471) | |
363AM0700X Physician Assistant, Medical (Licence: WA PA60433471) | |
Enumeration Date | 2013-02-08 |
Last Update Date | 2015-04-21 |