NPI | 1083609002 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MD C0007548) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085009493) |
363A00000X Physician Assistant (Licence: PA MA001866L) | |
363AM0700X Physician Assistant, Medical (Licence: IL 085.009493) | |
Enumeration Date | 2005-09-15 |
Last Update Date | 2024-06-19 |