| NPI | 1295966786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005746) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA06279) |
| Enumeration Date | 2009-07-31 |
| Last Update Date | 2017-01-17 |