NPI | 1750808127 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006565) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6894) |
Enumeration Date | 2017-08-27 |
Last Update Date | 2021-11-17 |