| NPI | 1053620443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085002790) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CO 3063) |
| Enumeration Date | 2010-10-02 |
| Last Update Date | 2010-10-02 |