NPI | 1871964676 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 60969) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NV 6263) |
363AM0700X Physician Assistant, Medical (Licence: NV PA1676) | |
Enumeration Date | 2015-10-19 |
Last Update Date | 2023-01-20 |