NPI | 1447739867 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA55804) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CA PA55804) |
Enumeration Date | 2018-08-07 |
Last Update Date | 2023-09-18 |