NPI | 1841813516 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085.008592) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008592) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2020-05-28 |
Last Update Date | 2023-01-24 |