NPI | 1881994432 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085.003819) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: IA 124234) | |
Enumeration Date | 2010-10-29 |
Last Update Date | 2024-01-23 |