NPI | 1720362262 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106252) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2011-10-03 |
Last Update Date | 2025-06-05 |