NPI | 1952800534 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61218057) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61218057) |
Enumeration Date | 2018-02-08 |
Last Update Date | 2024-09-25 |