NPI | 1841492089 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 002050) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 002050) |
363A00000X Physician Assistant (Licence: NY 012088) | |
Enumeration Date | 2007-06-01 |
Last Update Date | 2019-10-15 |