NPI | 1497934129 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 6654) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 012074) |
Enumeration Date | 2007-10-30 |
Last Update Date | 2013-06-07 |