NPI | 1689780959 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA 9103694) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA 051508) |
Enumeration Date | 2006-08-21 |
Last Update Date | 2024-10-18 |