NPI | 1487089686 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: CT 003116) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 016846) |
Enumeration Date | 2013-09-06 |
Last Update Date | 2015-03-24 |