NPI | 1558985416 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA062792) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9113181) |
Enumeration Date | 2020-06-05 |
Last Update Date | 2022-08-22 |