| NPI | 1104826361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085-002685) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA02580) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2021-02-24 |