NPI | 1528441243 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108801) |
Additional Taxonomies | 363AS0400X Physician Assistant Surgical (Licence: FL PA9108801) |
Enumeration Date | 2015-06-30 |
Last Update Date | 2023-10-26 |