NPI | 1023271632 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: OR PA195380) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003524) |
363AS0400X Physician Assistant Surgical (Licence: IL 085003524) | |
Enumeration Date | 2008-07-03 |
Last Update Date | 2023-01-10 |