NPI | 1396116992 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 6226) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AZ 6226) |
Enumeration Date | 2015-10-08 |
Last Update Date | 2024-07-30 |