NPI | 1417176132 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: LA A10436) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MS PA 037) |
Enumeration Date | 2007-04-24 |
Last Update Date | 2023-09-14 |