NPI | 1588474076 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA65477) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.011024) |
Enumeration Date | 2025-01-08 |
Last Update Date | 2025-01-08 |