NPI | 1396889127 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109641) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 009214) |
Enumeration Date | 2007-02-16 |
Last Update Date | 2021-03-15 |