NPI | 1619753498 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9117799) |
Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: FL PA9117799) |
Enumeration Date | 2023-09-06 |
Last Update Date | 2023-11-21 |