NPI | 1710590138 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114196) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-08-25 |
Last Update Date | 2024-02-16 |