NPI | 1508638057 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117794) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AS0400X Physician Assistant, Surgical (Licence: FL PA9117794) | |
Enumeration Date | 2023-10-27 |
Last Update Date | 2024-10-11 |