NPI | 1588118277 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.009448) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3846-23) |
Enumeration Date | 2016-08-10 |
Last Update Date | 2023-05-19 |