NPI | 1316488455 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110023) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL 9110023) |
Enumeration Date | 2017-03-08 |
Last Update Date | 2024-07-16 |