NPI | 1467862680 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60824358) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60824358) |
363AM0700X Physician Assistant, Medical (Licence: WA PA60824358) | |
Enumeration Date | 2014-04-28 |
Last Update Date | 2021-10-29 |