NPI | 1609863620 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.002335) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-002335) |
Enumeration Date | 2005-10-04 |
Last Update Date | 2023-11-07 |