NPI | 1649855826 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085008434) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085008434) |
Enumeration Date | 2021-03-10 |
Last Update Date | 2025-04-22 |