NPI | 1821497561 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3789) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0004011) |
363AS0400X Physician Assistant, Surgical (Licence: TX PA09902) | |
Enumeration Date | 2014-08-19 |
Last Update Date | 2022-08-29 |