NPI | 1316327877 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9108711) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.005564) |
Enumeration Date | 2015-05-31 |
Last Update Date | 2023-09-01 |