| NPI | 1194150466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 238000537) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: IL 237.000.132) |
| Enumeration Date | 2013-09-05 |
| Last Update Date | 2018-10-04 |