NPI | 1912928334 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0000129) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0002826) |
Enumeration Date | 2006-07-21 |
Last Update Date | 2018-04-03 |