NPI | 1861174211 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9116865) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL pa9116865) |
Enumeration Date | 2023-08-04 |
Last Update Date | 2024-01-08 |