NPI | 1740909639 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9116418) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-08-24 |
Last Update Date | 2024-10-01 |