| NPI | 1326278284 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-003518) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085-003518) |
| 363AS0400X Physician Assistant, Surgical (Licence: IN 10001119A) | |
| 363AM0700X Physician Assistant, Medical (Licence: IN 10001119A) | |
| 363AS0400X Physician Assistant, Surgical (Licence: WI 2685-023) | |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2012-02-22 |