NPI | 1083962229 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004395) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085004395) |
Enumeration Date | 2012-08-20 |
Last Update Date | 2022-01-17 |