NPI | 1780712232 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AZ 3609) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 3609) |
363AM0700X Physician Assistant, Medical (Licence: AZ 3609) | |
Enumeration Date | 2007-02-28 |
Last Update Date | 2021-07-08 |