NPI | 1831840552 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA063513) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: CA 60866) |
363AS0400X Physician Assistant Surgical (Licence: PA MA063513) | |
Enumeration Date | 2022-01-13 |
Last Update Date | 2023-08-29 |