NPI | 1760961494 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C0006902) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: DC PA031468) |
Enumeration Date | 2018-08-13 |
Last Update Date | 2018-08-13 |