NPI | 1841539954 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9108900) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026629-01) |
Enumeration Date | 2013-02-08 |
Last Update Date | 2024-04-17 |