NPI | 1548685787 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5650) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-004989) |
Enumeration Date | 2014-02-25 |
Last Update Date | 2025-03-03 |