NPI | 1669891131 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006055) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 51478) |
Enumeration Date | 2014-04-14 |
Last Update Date | 2017-10-11 |