NPI | 1528410305 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: LA 302034) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: LA 302034) |
Enumeration Date | 2016-07-06 |
Last Update Date | 2020-02-20 |