NPI | 1366932618 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MT MED-PAC-LIC-69514) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT MED-PAC-LIC-69514) |
Enumeration Date | 2018-05-12 |
Last Update Date | 2021-12-14 |