NPI | 1811316706 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA215743) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-06239) |
363A00000X Physician Assistant (Licence: FL PA9107823) | |
363A00000X Physician Assistant (Licence: CA 61677) | |
363AM0700X Physician Assistant, Medical (Licence: FL PA9107823) | |
Enumeration Date | 2014-04-08 |
Last Update Date | 2023-11-21 |