NPI | 1558471979 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110009837) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA051604) |
363A00000X Physician Assistant (Licence: MD C03721) | |
Enumeration Date | 2006-08-30 |
Last Update Date | 2024-05-10 |