NPI | 1992944904 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085003419) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2009001275) |
Enumeration Date | 2009-02-13 |
Last Update Date | 2010-07-21 |