NPI | 1487695516 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OR PA00414) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OR PA00414) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2016-04-05 |