NPI | 1215435151 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111896) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2018-01-25 |
Last Update Date | 2025-01-27 |