NPI | 1790278190 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA60598) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA195774) |
Enumeration Date | 2018-06-11 |
Last Update Date | 2023-10-03 |