NPI | 1265535678 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 385000368) |
Additional Taxonomies | 133V00000X Dietitian, Registered |
Enumeration Date | 2006-09-07 |
Last Update Date | 2014-04-22 |