NPI | 1972807964 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109740) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: FL CH7415) |
Enumeration Date | 2011-01-05 |
Last Update Date | 2016-11-28 |