NPI | 1720155476 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL 491) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AL PA491) |
Enumeration Date | 2006-11-29 |
Last Update Date | 2013-05-01 |