NPI | 1487902623 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106654) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9106654) |
Enumeration Date | 2012-08-20 |
Last Update Date | 2019-04-04 |