NPI | 1538398441 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9109794) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01846) |
363AS0400X Physician Assistant, Surgical (Licence: TN 1834) | |
Enumeration Date | 2009-07-13 |
Last Update Date | 2019-02-12 |