NPI | 1669066205 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA8000) |
Additional Taxonomies | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine (Licence: FL PA9117195) |
363A00000X Physician Assistant (Licence: FL PA9117195) | |
Enumeration Date | 2021-02-24 |
Last Update Date | 2025-03-25 |