NPI | 1710690623 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085.010294) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.010294) |
Enumeration Date | 2023-01-05 |
Last Update Date | 2025-03-31 |