NPI | 1871038513 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9109968) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9109968) |
Enumeration Date | 2017-01-05 |
Last Update Date | 2021-06-20 |