NPI | 1326486754 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114537) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2013-06-07 |
Last Update Date | 2021-10-25 |