NPI | 1063425031 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9104263) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9104263) |
363A00000X Physician Assistant (Licence: FL PA9104263) | |
Enumeration Date | 2006-08-14 |
Last Update Date | 2020-10-05 |