NPI | 1952973117 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-009005) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA14804) |
363AS0400X Physician Assistant, Surgical | |
Enumeration Date | 2021-07-15 |
Last Update Date | 2022-11-23 |