NPI | 1497487532 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085010097) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085010097) |
Enumeration Date | 2022-06-28 |
Last Update Date | 2023-11-13 |