NPI | 1053930511 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116121) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA2200) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-04-14 |
Last Update Date | 2022-10-25 |