NPI | 1942429204 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3566) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 01267) |
363A00000X Physician Assistant (Licence: FL PA 9103555) | |
363A00000X Physician Assistant (Licence: VA 0110006167) | |
Enumeration Date | 2007-04-25 |
Last Update Date | 2021-05-12 |