| NPI | 1396154233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085.005104) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CT 4933) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2020-12-31 |