NPI | 1518007301 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA051443) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 5203) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2020-08-10 |