| NPI | 1356748024 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA MA058512) | 
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085005145) | 
| Enumeration Date | 2014-11-24 | 
| Last Update Date | 2017-02-27 |