NPI | 1881222354 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61623) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007809) |
207Q00000X Family Medicine (Licence: IL 085.007809) | |
Enumeration Date | 2020-03-31 |
Last Update Date | 2022-10-17 |