| NPI | 1386975183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 0110003385) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003563) |
| Enumeration Date | 2010-01-19 |
| Last Update Date | 2011-06-13 |