| NPI | 1124365051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA60853) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004569) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2023-06-12 |