| NPI | 1427349364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-005496) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014632-1) |
| 363AS0400X Physician Assistant, Surgical (Licence: CO 0003839) | |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2015-11-30 |