| NPI | 1245486158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01571) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085003685) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2013-12-03 |