NPI | 1093091308 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085004057) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004057) |
Enumeration Date | 2011-11-01 |
Last Update Date | 2017-11-03 |