NPI | 1871048629 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9114023) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
363A00000X Physician Assistant | |
363A00000X Physician Assistant (Licence: FL PA9114023) | |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2016-08-22 |
Last Update Date | 2024-05-23 |