NPI | 1477311645 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085010376) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: IL 085010376) | |
Enumeration Date | 2024-03-11 |
Last Update Date | 2024-05-15 |