NPI | 1407816234 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9112255) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL APRN9112255) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL APRN9112255) | |
363AM0700X Physician Assistant, Medical (Licence: NC 103487) | |
363AM0700X Physician Assistant, Medical (Licence: FL 9112255) | |
363AS0400X Physician Assistant, Surgical (Licence: NC 103487) | |
Enumeration Date | 2006-03-24 |
Last Update Date | 2022-08-11 |