NPI | 1679109789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085007705) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007705) |
Enumeration Date | 2020-03-20 |
Last Update Date | 2025-09-18 |