NPI | 1992781124 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: HI AMD-521) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: HI AMD-521) |
Enumeration Date | 2005-12-20 |
Last Update Date | 2014-07-17 |