NPI | 1376870931 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 20969) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085.003647) |
Enumeration Date | 2009-11-03 |
Last Update Date | 2014-04-07 |