| NPI | 1124434014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: PA DN004758) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085006742) | |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2023-07-11 |