NPI | 1750725685 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 22914) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OR PA175553) |
Enumeration Date | 2013-04-22 |
Last Update Date | 2016-03-09 |