NPI | 1649605684 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA187058) |
Additional Taxonomies | 207KA0200X Allergy & Immunology, Allergy (Licence: OR PA187058) |
363A00000X Physician Assistant (Licence: OR PA187058) | |
363AM0700X Physician Assistant, Medical (Licence: IL 085.004709) | |
Enumeration Date | 2013-09-10 |
Last Update Date | 2024-09-11 |