NPI | 1548855380 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9114230) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2021-03-03 |
Last Update Date | 2022-03-29 |