NPI | 1649833021 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110007026) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110007026) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-04-21 |
Last Update Date | 2022-08-18 |