NPI | 1760260319 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9118193) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2023-09-15 |
Last Update Date | 2024-01-17 |