| NPI | 1386645604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001468) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002642) |
| 363AS0400X Physician Assistant, Surgical (Licence: IA 001468) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2011-09-21 |