NPI | 1720060833 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA2618) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA2618) |
Enumeration Date | 2005-11-15 |
Last Update Date | 2022-10-28 |