| NPI | 1245686211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56657) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.005804) |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2019-09-05 |