NPI | 1689060022 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: SC 3069) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3069) |
Enumeration Date | 2015-04-13 |
Last Update Date | 2018-11-07 |