NPI | 1942990957 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117214) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2023-05-11 |
Last Update Date | 2023-08-30 |