NPI | 1487050175 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005184) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14672) |
Enumeration Date | 2014-11-07 |
Last Update Date | 2022-07-07 |