NPI | 1558761247 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05208) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-05208) |
Enumeration Date | 2014-08-29 |
Last Update Date | 2021-03-30 |