| NPI | 1316668494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085010139) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.010139) |
| Enumeration Date | 2022-09-07 |
| Last Update Date | 2024-02-27 |