NPI | 1912972340 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA58457) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NE 1247) |
Enumeration Date | 2006-02-20 |
Last Update Date | 2021-11-16 |