| NPI | 1336312693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085005433) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2002001000) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2022-08-31 |