NPI | 1831500420 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9119501) |
Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL PTA22412) |
363A00000X Physician Assistant (Licence: FL PA9119501) | |
363AM0700X Physician Assistant, Medical (Licence: FL PA9119501) | |
Enumeration Date | 2014-05-16 |
Last Update Date | 2025-06-17 |