| NPI | 1003399981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 56590) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: IL 085.006694) |
| Enumeration Date | 2018-09-07 |
| Last Update Date | 2019-12-21 |