NPI | 1477067239 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 5030) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO PA.0005175) |
363A00000X Physician Assistant (Licence: CA 62769) | |
Enumeration Date | 2017-11-30 |
Last Update Date | 2023-06-29 |