NPI | 1902188147 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-940) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2011-09-14 |
Last Update Date | 2017-07-27 |