NPI | 1679669402 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9108555) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108555) |
Enumeration Date | 2006-10-05 |
Last Update Date | 2019-05-10 |