NPI | 1720470305 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA116713) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-05546) |
Enumeration Date | 2015-02-19 |
Last Update Date | 2023-02-03 |