NPI | 1871866848 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA54712) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9106450) |
Enumeration Date | 2012-02-21 |
Last Update Date | 2020-09-08 |