| NPI | 1013376201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.008195) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10470) |
| Enumeration Date | 2016-02-16 |
| Last Update Date | 2021-06-04 |