NPI | 1295500189 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023044681) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 85.010028) |
Enumeration Date | 2023-11-20 |
Last Update Date | 2025-08-20 |