| NPI | 1063870525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 55181) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 085.005717) |
| 363A00000X Physician Assistant (Licence: IL 085.005717) | |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2018-04-04 |