| NPI | 1023092319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 05500339) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002397) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2015-02-04 |