NPI | 1053819680 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9110959) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 9110959) |
Enumeration Date | 2018-01-29 |
Last Update Date | 2024-05-17 |