NPI | 1982031910 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 079216) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5578) |
363AS0400X Physician Assistant Surgical (Licence: AZ 5578) | |
Enumeration Date | 2013-10-04 |
Last Update Date | 2021-09-21 |