NPI | 1962957662 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058288) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA058288) |
Enumeration Date | 2016-08-23 |
Last Update Date | 2020-10-08 |