NPI | 1942622493 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9107727) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107727) |
363AS0400X Physician Assistant, Surgical (Licence: FL PA9107727) | |
Enumeration Date | 2014-01-16 |
Last Update Date | 2017-01-09 |