NPI | 1700260171 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006184) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085006184) |
363AM0700X Physician Assistant, Medical (Licence: IN 10001860A) | |
Enumeration Date | 2015-07-16 |
Last Update Date | 2018-03-17 |