NPI | 1578935193 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2022-0112) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 019194-1) |
Enumeration Date | 2015-10-22 |
Last Update Date | 2024-06-12 |