NPI | 1548681026 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 003042) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 003042) |
363AM0700X Physician Assistant, Medical (Licence: CT 003042) | |
Enumeration Date | 2013-12-30 |
Last Update Date | 2022-09-28 |