NPI | 1932405453 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA21457) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA21457) |
Enumeration Date | 2011-01-31 |
Last Update Date | 2012-04-19 |