NPI | 1649651779 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116050) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
363AM0700X Physician Assistant, Medical (Licence: RI PA00818) | |
Enumeration Date | 2015-06-15 |
Last Update Date | 2024-11-20 |