NPI | 1881106359 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-008855) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: UT 10562585-1206) |
Enumeration Date | 2017-10-24 |
Last Update Date | 2023-10-16 |