NPI | 1235206483 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9116508) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA18711) |
Enumeration Date | 2006-11-30 |
Last Update Date | 2023-11-16 |