NPI | 1376289033 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2644) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: WV TEMP2965) | |
Enumeration Date | 2022-05-06 |
Last Update Date | 2023-07-19 |