NPI | 1902578016 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9115112) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-09-28 |
Last Update Date | 2022-09-25 |