NPI | 1669090023 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 4536) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: TN 4536) | |
Enumeration Date | 2020-07-10 |
Last Update Date | 2022-03-16 |