NPI | 1538551288 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61122674) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IN 99066180A) |
Enumeration Date | 2015-03-04 |
Last Update Date | 2021-02-22 |