NPI | 1760575013 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9108653) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 011398) |
Enumeration Date | 2006-10-01 |
Last Update Date | 2018-12-26 |