NPI | 1225791486 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116706) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 10650) |
Enumeration Date | 2021-10-14 |
Last Update Date | 2023-06-23 |