NPI | 1790109981 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN PA2465) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TN PA2465) |
Enumeration Date | 2014-02-10 |
Last Update Date | 2020-09-03 |