| NPI | 1376870931 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CA 20969) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: IL 085.003647) |
| Enumeration Date | 2009-11-03 |
| Last Update Date | 2014-04-07 |