NPI | 1760633382 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 64265) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.003762) |
363AS0400X Physician Assistant, Surgical (Licence: VA 0110002884) | |
Enumeration Date | 2008-10-01 |
Last Update Date | 2024-05-22 |