NPI | 1932421989 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105305) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9105305) |
Enumeration Date | 2010-02-18 |
Last Update Date | 2022-08-15 |