NPI | 1558617910 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085004375) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07303) |
363A00000X Physician Assistant (Licence: IL 085004375) | |
Enumeration Date | 2012-08-02 |
Last Update Date | 2025-03-20 |