NPI | 1932484946 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 3224) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 05004170) |
Enumeration Date | 2011-10-21 |
Last Update Date | 2013-12-10 |