NPI | 1033751169 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085.010009) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IL 164009188) |
Enumeration Date | 2019-10-09 |
Last Update Date | 2023-10-15 |