NPI | 1801655071 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9118505) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2024-03-18 |
Last Update Date | 2024-06-14 |