NPI | 1104150382 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085003601) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-003601) |
Enumeration Date | 2009-09-22 |
Last Update Date | 2021-12-16 |