NPI | 1578219762 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 60825) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 60825) |
Enumeration Date | 2022-02-25 |
Last Update Date | 2022-10-19 |