| NPI | 1063597136 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4420) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002850) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2012-03-02 |