| NPI | 1912759275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: IL 085010427) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 085.010427) |
| 207R00000X Internal Medicine (Licence: IL 085.010427) | |
| Enumeration Date | 2024-04-02 |
| Last Update Date | 2024-07-09 |