NPI | 1003391616 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113488) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085006726) |
Enumeration Date | 2018-09-28 |
Last Update Date | 2022-01-27 |