NPI | 1760957328 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111682) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111682) |
Enumeration Date | 2018-10-10 |
Last Update Date | 2019-04-04 |