| NPI | 1376733279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4245) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: AZ 4245) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085002990) | |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2025-03-05 |