NPI | 1518010966 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WI 1289) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NM 2001-PA32) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2011-08-01 |