NPI | 1174660476 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9102356) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9102356) |
Enumeration Date | 2007-01-30 |
Last Update Date | 2023-08-16 |