NPI | 1558402065 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA62193) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 011496-1) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2024-06-18 |