NPI | 1932487568 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA0110634) |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2011-08-01 |
Last Update Date | 2024-02-07 |