NPI | 1023419728 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108228) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9108228) |
Enumeration Date | 2014-09-12 |
Last Update Date | 2021-01-27 |