NPI | 1811625437 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA063843) |
Additional Taxonomies | 208D00000X General Practice (Licence: PA MA063843) |
208200000X Plastic Surgery (Licence: PA MA063843) | |
Enumeration Date | 2022-08-11 |
Last Update Date | 2022-11-05 |