NPI | 1164901864 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085007408) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0006904) |
Enumeration Date | 2018-08-13 |
Last Update Date | 2022-05-13 |