NPI | 1548737331 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4685) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA2416) |
363AS0400X Physician Assistant Surgical (Licence: TN 4685) | |
Enumeration Date | 2018-10-30 |
Last Update Date | 2022-08-15 |