NPI | 1730329202 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000648) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: DE CS-0000648) |
363AS0400X Physician Assistant, Surgical (Licence: NY 013645) | |
Enumeration Date | 2009-02-24 |
Last Update Date | 2021-03-15 |