NPI | 1508007287 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9104696) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA09022) |
Enumeration Date | 2009-03-10 |
Last Update Date | 2014-09-10 |