| NPI | 1215923776 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 001380) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085-001698) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2015-05-13 |