NPI | 1376992081 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111087) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2016-06-03 |
Last Update Date | 2019-05-23 |