NPI | 1629116728 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA002230-L) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA OA003364) |
Enumeration Date | 2007-02-01 |
Last Update Date | 2025-02-21 |