| NPI | 1114913654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085001792) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085001792) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2008-05-30 |