NPI | 1316402282 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-007221) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA56527) |
363A00000X Physician Assistant (Licence: GA 11251) | |
Enumeration Date | 2019-02-05 |
Last Update Date | 2023-10-13 |