NPI | 1710320098 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 4625) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA PA4625) |
Enumeration Date | 2013-04-17 |
Last Update Date | 2014-11-12 |