NPI | 1508887779 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 000222) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 000222) |
Enumeration Date | 2006-07-22 |
Last Update Date | 2015-09-15 |