NPI | 1912272113 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9106401) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9106401) |
Enumeration Date | 2012-03-21 |
Last Update Date | 2014-08-26 |