NPI | 1235680877 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006155) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3916) |
Enumeration Date | 2016-10-19 |
Last Update Date | 2018-03-17 |