NPI | 1942727722 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9100937) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9100937) |
Enumeration Date | 2017-08-23 |
Last Update Date | 2021-10-12 |