NPI | 1891462925 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9120071) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: GA 11283) | |
Enumeration Date | 2021-08-26 |
Last Update Date | 2025-09-10 |