NPI | 1407970395 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 85000407) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 0850000407) |
Enumeration Date | 2007-03-18 |
Last Update Date | 2024-07-31 |