NPI | 1396455630 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009405) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003889A) |
363A00000X Physician Assistant (Licence: WI 7205-23) | |
363A00000X Physician Assistant | |
Enumeration Date | 2022-11-28 |
Last Update Date | 2023-01-09 |