NPI | 1982330296 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA PA61378) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA61378) |
Enumeration Date | 2022-07-28 |
Last Update Date | 2022-11-30 |