| NPI | 1396940375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.002734) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IN 10000869A) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2015-06-05 |