NPI | 1669718870 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD c0002620) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD c0002620) |
Enumeration Date | 2012-12-14 |
Last Update Date | 2012-12-14 |