NPI | 1861620114 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA223210) |
Additional Taxonomies | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TN 4402) |
363A00000X Physician Assistant (Licence: TN 4402) | |
363AS0400X Physician Assistant, Surgical (Licence: TN 4402) | |
Enumeration Date | 2009-06-25 |
Last Update Date | 2025-04-08 |