| NPI | 1366927741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IN 085006761) |
| Additional Taxonomies | 208D00000X General Practice (Licence: IL 085006761) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2018-10-10 |