NPI | 1487129615 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9115314) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA060354) |
Enumeration Date | 2018-10-03 |
Last Update Date | 2023-02-02 |