NPI | 1366401705 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107831) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 10775) |
Enumeration Date | 2006-03-23 |
Last Update Date | 2023-01-11 |