NPI | 1104443258 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5318-23) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008097) |
Enumeration Date | 2020-07-05 |
Last Update Date | 2021-12-31 |