NPI | 1508033218 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052852) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 85-003727) |
Enumeration Date | 2008-05-12 |
Last Update Date | 2015-02-23 |