| NPI | 1003992884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06637) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002767) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2022-10-19 |