NPI | 1235526526 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108803) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2015-04-24 |
Last Update Date | 2023-09-15 |