NPI | 1922670306 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116697) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 1177817) |
Enumeration Date | 2021-07-14 |
Last Update Date | 2024-12-03 |