NPI | 1861724353 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 20824) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 20824) |
Enumeration Date | 2010-02-08 |
Last Update Date | 2022-02-11 |