NPI | 1639939036 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9119023) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2024-03-21 |
Last Update Date | 2024-09-09 |