NPI | 1134634330 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA59770) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006427) |
Enumeration Date | 2017-12-10 |
Last Update Date | 2022-04-19 |