NPI | 1851730717 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004948) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055939) |
363A00000X Physician Assistant (Licence: DE C5-0000857) | |
Enumeration Date | 2013-06-24 |
Last Update Date | 2016-07-19 |