NPI | 1427838614 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 6385) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 6385) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2023-10-04 |
Last Update Date | 2023-12-18 |