NPI | 1245304310 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9104258) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 006974) |
Enumeration Date | 2006-11-20 |
Last Update Date | 2021-03-15 |