NPI | 1528333192 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: HI AMD490) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AS0400X Physician Assistant, Surgical (Licence: FL 9106513) | |
Enumeration Date | 2012-03-15 |
Last Update Date | 2021-06-03 |