NPI | 1932298429 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 0454) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4054) |
363AS0400X Physician Assistant, Surgical (Licence: GA 006236) | |
Enumeration Date | 2006-10-12 |
Last Update Date | 2022-12-12 |