NPI | 1790570414 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9120182) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2025-04-12 |
Last Update Date | 2025-06-26 |