NPI | 1538168067 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 54269) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105108) |
363AM0700X Physician Assistant, Medical (Licence: SC A447) | |
363AS0400X Physician Assistant, Surgical (Licence: SC 447) | |
Enumeration Date | 2005-07-18 |
Last Update Date | 2019-10-25 |