NPI | 1649354812 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109519) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA052770) |
Enumeration Date | 2006-10-24 |
Last Update Date | 2019-09-11 |