NPI | 1831526078 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MD C0005235) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016758) |
Enumeration Date | 2013-10-02 |
Last Update Date | 2015-07-28 |