NPI | 1932127255 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA2704) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 2704) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2023-06-27 |