NPI | 1386181667 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9115755) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 020543) |
Enumeration Date | 2017-01-25 |
Last Update Date | 2024-04-11 |