NPI | 1497891337 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103529) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL pa9103529) |
Enumeration Date | 2007-01-29 |
Last Update Date | 2024-01-25 |