NPI | 1083276695 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.007094) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085007094) |
Enumeration Date | 2019-07-03 |
Last Update Date | 2022-01-27 |