NPI | 1194020529 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN tn2516) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9105864) |
363A00000X Physician Assistant (Licence: FL PAT9105864) | |
Enumeration Date | 2011-01-15 |
Last Update Date | 2016-06-11 |