NPI | 1679704498 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60147977) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085003522) |
Enumeration Date | 2009-07-28 |
Last Update Date | 2021-06-08 |