NPI | 1376720011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA3591) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA3591) |
Enumeration Date | 2008-01-24 |
Last Update Date | 2023-07-06 |