NPI | 1033250576 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-002903) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 036-087287) |
Enumeration Date | 2007-02-09 |
Last Update Date | 2021-11-09 |