NPI | 1235884305 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12781) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9115696) |
Enumeration Date | 2022-02-17 |
Last Update Date | 2025-02-03 |