NPI | 1104069004 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3204) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105046) |
Enumeration Date | 2009-04-08 |
Last Update Date | 2023-02-16 |