NPI | 1598243750 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114347) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C07010) |
Enumeration Date | 2018-07-31 |
Last Update Date | 2025-01-15 |