NPI | 1588835953 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2019004448) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53424) |
363A00000X Physician Assistant (Licence: IL 085003197) | |
Enumeration Date | 2008-03-13 |
Last Update Date | 2024-08-08 |