| NPI | 1376978940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: IL 085004734) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 85004734) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2016-04-11 |