NPI | 1790021186 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51911) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004495) |
Enumeration Date | 2012-12-12 |
Last Update Date | 2015-06-04 |