NPI | 1942335492 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104589) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 011476) |
Enumeration Date | 2007-02-23 |
Last Update Date | 2022-01-14 |