NPI | 1780053793 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60698227) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60698227) |
Enumeration Date | 2015-09-20 |
Last Update Date | 2022-08-11 |