NPI | 1497030571 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105117) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105117) |
Enumeration Date | 2011-10-20 |
Last Update Date | 2023-07-26 |