NPI | 1316472723 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9117705) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2017-04-23 |
Last Update Date | 2024-11-14 |