| NPI | 1235215633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085001985) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KS 15-02563) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2022-02-14 |