NPI | 1366670309 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 2745) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085003475) |
Enumeration Date | 2009-06-29 |
Last Update Date | 2019-10-21 |