NPI | 1417088071 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-002589) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA053428) |
Enumeration Date | 2007-03-07 |
Last Update Date | 2016-03-15 |