| NPI | 1275816167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.004238) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055067) |
| Enumeration Date | 2011-09-27 |
| Last Update Date | 2011-11-16 |