NPI | 1447580840 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9114846) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 002890) |
Enumeration Date | 2010-01-06 |
Last Update Date | 2024-05-07 |