NPI | 1851859599 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2238) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: WV 2238) |
Enumeration Date | 2019-03-12 |
Last Update Date | 2019-03-12 |