NPI | 1780213553 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085008403) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-04-03 |
Last Update Date | 2024-06-03 |