| NPI | 1275727315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006483) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001053A) |
| Enumeration Date | 2007-08-31 |
| Last Update Date | 2021-12-13 |