NPI | 1932504206 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TN 2635) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 2635) |
363AM0700X Physician Assistant, Medical (Licence: TN 2635) | |
Enumeration Date | 2014-10-29 |
Last Update Date | 2022-03-29 |