NPI | 1952610461 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9109681) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 014892) |
Enumeration Date | 2010-09-30 |
Last Update Date | 2019-08-27 |