NPI | 1033192349 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103545) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA pa21515) |
363A00000X Physician Assistant (Licence: NM PA2009-0035) | |
Enumeration Date | 2005-11-22 |
Last Update Date | 2024-08-16 |