NPI | 1497085526 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA054280) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 003736) |
363AS0400X Physician Assistant, Surgical (Licence: CT 003736) | |
Enumeration Date | 2010-01-13 |
Last Update Date | 2020-12-18 |