NPI | 1326696873 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114646) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0007215) |
Enumeration Date | 2019-08-28 |
Last Update Date | 2022-12-11 |