NPI | 1881170686 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9118175) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 022161-1) |
Enumeration Date | 2018-07-15 |
Last Update Date | 2024-03-27 |