NPI | 1902109127 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003438) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: VA 0110003438) |
Enumeration Date | 2010-12-09 |
Last Update Date | 2020-10-21 |