NPI | 1386314912 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA064789) |
Additional Taxonomies | 2086S0127X Surgery, Trauma Surgery (Licence: PA MA064789) |
Enumeration Date | 2021-09-15 |
Last Update Date | 2025-09-03 |