NPI | 1316606338 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008938) |
Additional Taxonomies | 363A00000X Physician Assistant |
363AS0400X Physician Assistant, Surgical (Licence: IL 085008938) | |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2021-12-17 |
Last Update Date | 2024-03-05 |