NPI | 1649578279 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-004668) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23014665) |
363A00000X Physician Assistant (Licence: FL PA9106434) | |
Enumeration Date | 2011-03-07 |
Last Update Date | 2013-10-11 |