NPI | 1588120505 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4584) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 4584) |
Enumeration Date | 2019-02-14 |
Last Update Date | 2021-05-24 |