NPI | 1093706079 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA2518) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA2518) |
Enumeration Date | 2005-10-31 |
Last Update Date | 2023-11-06 |