NPI | 1609163211 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA4205) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA4205) |
Enumeration Date | 2011-07-03 |
Last Update Date | 2020-10-28 |