NPI | 1760493100 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NH 0163) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VT 0550030216) |
Enumeration Date | 2006-08-10 |
Last Update Date | 2010-05-24 |