NPI | 1497246581 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111363) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: FL PA9111363) | |
Enumeration Date | 2018-05-23 |
Last Update Date | 2023-04-06 |