NPI | 1427191667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03722) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-03722) |
363AS0400X Physician Assistant, Surgical (Licence: NY 013063) | |
Enumeration Date | 2007-02-15 |
Last Update Date | 2019-09-26 |