| NPI | 1356693006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.004954) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5275) |
| Enumeration Date | 2012-10-04 |
| Last Update Date | 2018-02-21 |