NPI | 1659725976 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109562) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109562) |
Enumeration Date | 2016-04-22 |
Last Update Date | 2023-02-28 |