NPI | 1740650316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006613) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: ID PA1292) |
363AS0400X Physician Assistant, Surgical (Licence: ID PA1292) | |
Enumeration Date | 2015-09-25 |
Last Update Date | 2024-01-31 |