NPI | 1841387735 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106347) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 102514) |
Enumeration Date | 2006-10-10 |
Last Update Date | 2012-04-04 |