NPI | 1245648344 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005800) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4010) |
363A00000X Physician Assistant (Licence: CT 23.003158) | |
Enumeration Date | 2014-08-01 |
Last Update Date | 2022-07-21 |