NPI | 1972024701 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA56713) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006167) |
363A00000X Physician Assistant | |
Enumeration Date | 2017-07-01 |
Last Update Date | 2024-08-28 |