NPI | 1427092758 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WV 0528) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052238) |
363AS0400X Physician Assistant, Surgical (Licence: PA MA052238) | |
Enumeration Date | 2006-06-16 |
Last Update Date | 2021-01-11 |