| NPI | 1366445975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001009744) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002145) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2022-01-13 |