NPI | 1780300483 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9116616) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9116616) |
Enumeration Date | 2022-10-13 |
Last Update Date | 2024-09-06 |