NPI | 1417307737 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: DC PA031417) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: VA 1135016) |
363A00000X Physician Assistant (Licence: DC PA031417) | |
Enumeration Date | 2016-06-17 |
Last Update Date | 2018-03-17 |