| NPI | 1013332261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004863) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA 9107575) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2014-02-25 |