| NPI | 1396721189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005568) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DC PA30148) |
| 363A00000X Physician Assistant (Licence: LA PA200169) | |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2015-07-24 |