NPI | 1508377953 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60417) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 021485) |
Enumeration Date | 2017-10-12 |
Last Update Date | 2022-12-09 |