NPI | 1013979731 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9101411) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AS0400X Physician Assistant, Surgical (Licence: FL PA9101411) | |
Enumeration Date | 2006-04-06 |
Last Update Date | 2022-10-31 |