NPI | 1356056188 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085.009437) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10004851A) |
Enumeration Date | 2023-01-17 |
Last Update Date | 2025-07-16 |