NPI | 1831765494 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9118742) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085008156) |
Enumeration Date | 2021-06-02 |
Last Update Date | 2024-10-10 |