NPI | 1992370001 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114595) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2021-05-21 |
Last Update Date | 2024-06-07 |