NPI | 1114913654 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085001792) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085001792) |
Enumeration Date | 2005-09-20 |
Last Update Date | 2008-05-30 |