NPI | 1528546074 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA57289) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT pending) |
Enumeration Date | 2018-08-06 |
Last Update Date | 2019-12-18 |