NPI | 1376000653 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA100351) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007228) |
Enumeration Date | 2019-02-22 |
Last Update Date | 2024-08-27 |