NPI | 1578544045 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9101933) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363AM0700X Physician Assistant, Medical (Licence: FL PA9101933) | |
Enumeration Date | 2005-11-10 |
Last Update Date | 2023-04-10 |