NPI | 1366037293 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9112876) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 9112876) |
Enumeration Date | 2021-03-03 |
Last Update Date | 2024-09-27 |