| NPI | 1386663383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103447) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002677) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-11-16 |