| NPI | 1326322470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085004543) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA 055095) |
| Enumeration Date | 2011-10-07 |
| Last Update Date | 2015-10-07 |