NPI | 1205292059 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.006560) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2016-01-10 |
Last Update Date | 2021-03-22 |