NPI | 1053656116 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 002348) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IA 002348) |
363AS0400X Physician Assistant, Surgical (Licence: IA 002348) | |
363A00000X Physician Assistant (Licence: IL 085.004555) | |
Enumeration Date | 2012-11-30 |
Last Update Date | 2024-05-02 |