NPI | 1629407366 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004913) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14190) |
Enumeration Date | 2013-11-04 |
Last Update Date | 2023-02-07 |