NPI | 1376950816 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.005076) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085.005076) |
Enumeration Date | 2014-07-16 |
Last Update Date | 2021-01-29 |