NPI | 1134733488 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116964) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-09-03 |
Last Update Date | 2023-03-11 |