NPI | 1053466763 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085.010556) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2024022107) |
Enumeration Date | 2007-01-24 |
Last Update Date | 2025-03-17 |