NPI | 1083665459 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104786) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA052039) |
363AM0700X Physician Assistant, Medical (Licence: FL PA9104786) | |
363AS0400X Physician Assistant, Surgical (Licence: FL PA9104786) | |
Enumeration Date | 2006-05-12 |
Last Update Date | 2016-02-23 |