NPI | 1407398266 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IN 10002156A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53853) |
Enumeration Date | 2016-11-10 |
Last Update Date | 2021-12-06 |