| NPI | 1386659746 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-01267) | 
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085001942) | 
| Enumeration Date | 2006-07-31 | 
| Last Update Date | 2016-03-30 |