| NPI | 1255890869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 095841) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006961) |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2021-08-10 |