NPI | 1881200202 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-14046) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-14046) |
Enumeration Date | 2020-09-21 |
Last Update Date | 2024-04-18 |