NPI | 1366043077 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PR 001726) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: FL 9626530) |
246ZC0007X Specialist/Technologist, Other, Surgical Assistant | |
363A00000X Physician Assistant (Licence: FL TPPA596) | |
Enumeration Date | 2020-11-08 |
Last Update Date | 2024-04-07 |