NPI | 1699024562 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9106682) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106682) |
Enumeration Date | 2012-09-06 |
Last Update Date | 2025-01-02 |