NPI | 1982338349 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 8098-23) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: IL 085010164) | |
Enumeration Date | 2022-07-12 |
Last Update Date | 2025-02-05 |