NPI | 1285060566 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111177) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016971-1) |
363A00000X Physician Assistant (Licence: NE 2229) | |
363A00000X Physician Assistant (Licence: TX PA11020) | |
363A00000X Physician Assistant (Licence: VA 0110006162) | |
Enumeration Date | 2013-09-18 |
Last Update Date | 2025-06-12 |