NPI | 1376507582 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA2459) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA2459) |
Enumeration Date | 2006-04-14 |
Last Update Date | 2021-07-23 |