| NPI | 1184084006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008526) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VT 055.0031291) |
| 363AS0400X Physician Assistant, Surgical (Licence: VT 0550031291) | |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2021-08-15 |