NPI | 1649555012 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 8904) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 015219) |
Enumeration Date | 2011-10-18 |
Last Update Date | 2024-04-05 |