NPI | 1043696180 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085.006244) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MA in process) |
Enumeration Date | 2015-07-30 |
Last Update Date | 2023-11-06 |