NPI | 1376050898 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9110694) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9110694) |
Enumeration Date | 2018-01-05 |
Last Update Date | 2023-09-18 |