NPI | 1750621009 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C0004997) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MD C0004997) |
Enumeration Date | 2013-02-25 |
Last Update Date | 2016-12-05 |