NPI | 1821166505 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085-002283) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 385-001166) |
Enumeration Date | 2006-12-01 |
Last Update Date | 2010-05-13 |