NPI | 1417198219 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA110222) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: KY PA1109) |
Enumeration Date | 2009-03-09 |
Last Update Date | 2020-12-14 |