NPI | 1144794785 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111932) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-01-16 |
Last Update Date | 2023-02-20 |