NPI | 1063691053 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.005170) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2198023) |
Enumeration Date | 2007-10-26 |
Last Update Date | 2020-01-31 |