NPI | 1457842924 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110-006205) |
Enumeration Date | 2018-05-21 |
Last Update Date | 2021-12-08 |