| NPI | 1164901864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085007408) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: MD C0006904) |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2022-05-13 |