NPI | 1689905044 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9107847) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OK 2038) |
363A00000X Physician Assistant (Licence: TX PA06395) | |
Enumeration Date | 2010-01-26 |
Last Update Date | 2018-04-22 |