NPI | 1083231419 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118829) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-07-01 |
Last Update Date | 2024-10-12 |