| NPI | 1154477917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA056822) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 08500715) |
| 363A00000X Physician Assistant (Licence: PA OA003460) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2015-05-14 |