NPI | 1629056742 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA050768) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA050768) |
Enumeration Date | 2006-01-09 |
Last Update Date | 2016-06-07 |