NPI | 1871103382 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-12366) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12366) |
Enumeration Date | 2020-08-10 |
Last Update Date | 2025-08-06 |