NPI | 1861867467 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL 9109217) |
Additional Taxonomies | 207Y00000X Otolaryngology (Licence: FL 9109217) |
Enumeration Date | 2015-12-08 |
Last Update Date | 2020-12-02 |