NPI | 1780962316 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106034) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106034) |
Enumeration Date | 2011-08-01 |
Last Update Date | 2023-04-12 |