NPI | 1659820231 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: UT 11419794) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6429) |
Enumeration Date | 2016-09-24 |
Last Update Date | 2021-08-10 |