NPI | 1750034104 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115739) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2022-01-26 |
Last Update Date | 2024-07-20 |