| NPI | 1023609278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: IL 085008899) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085008899) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-01-31 |
| Last Update Date | 2022-05-23 |