NPI | 1356883532 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111213) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058733) |
363A00000X Physician Assistant (Licence: PA OA003978) | |
Enumeration Date | 2016-11-05 |
Last Update Date | 2018-10-09 |