NPI | 1548584824 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053652) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA053652) |
Enumeration Date | 2010-03-16 |
Last Update Date | 2020-03-11 |