NPI | 1679199913 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 4935) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-06-23 |
Last Update Date | 2020-10-02 |