NPI | 1487843595 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9104304) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-003587) |
363A00000X Physician Assistant | |
363A00000X Physician Assistant (Licence: MD C0004536) | |
363A00000X Physician Assistant (Licence: TX PA06931) | |
Enumeration Date | 2007-10-15 |
Last Update Date | 2020-09-11 |