NPI | 1174680524 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.001826) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085001826) |
363AM0700X Physician Assistant, Medical (Licence: IL 085001826) | |
Enumeration Date | 2007-01-03 |
Last Update Date | 2024-03-28 |