NPI | 1518426774 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9194) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical |
363AS0400X Physician Assistant Surgical | |
Enumeration Date | 2019-03-18 |
Last Update Date | 2021-10-13 |