NPI | 1780147280 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113559) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-04-11 |
Last Update Date | 2022-04-13 |