NPI | 1982084950 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9108740) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 60919) |
Enumeration Date | 2015-06-04 |
Last Update Date | 2024-07-21 |