NPI | 1356606552 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4067-23) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WI 4067-23) |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2012-07-12 |
Last Update Date | 2021-01-13 |