NPI | 1033671532 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114035) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
363A00000X Physician Assistant (Licence: 1175088) | |
Enumeration Date | 2019-04-03 |
Last Update Date | 2022-02-02 |