NPI | 1598324477 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9117684) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE C5-0001323) |
363A00000X Physician Assistant (Licence: MO 2022013937) | |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2019-06-13 |
Last Update Date | 2024-06-16 |