NPI | 1932522141 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9107774) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PAT 9107774) |
Enumeration Date | 2014-01-23 |
Last Update Date | 2016-07-27 |