NPI | 1083275895 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007527) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NH 1577) |
Enumeration Date | 2019-06-23 |
Last Update Date | 2022-12-08 |