NPI | 1962737684 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: SC 1473) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: SC 1473) |
Enumeration Date | 2009-10-14 |
Last Update Date | 2015-06-03 |