NPI | 1952844623 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: SC 2675) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2675) |
363AM0700X Physician Assistant, Medical (Licence: SC 2675) | |
Enumeration Date | 2016-11-29 |
Last Update Date | 2021-08-25 |