NPI | 1518291491 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ID PA-817) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: ID PA-817) |
Enumeration Date | 2009-09-25 |
Last Update Date | 2021-02-09 |