NPI | 1285260661 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9114894) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT9114894) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-03-18 |
Last Update Date | 2022-03-07 |