NPI | 1952652604 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 5209) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 5209) |
Enumeration Date | 2012-09-20 |
Last Update Date | 2013-11-07 |