NPI | 1932451283 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106912) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9106912) |
Enumeration Date | 2012-10-11 |
Last Update Date | 2021-10-13 |