NPI | 1114418910 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007454) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9111278) |
Enumeration Date | 2018-05-29 |
Last Update Date | 2024-12-09 |