| NPI | 1447214648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: AK 118995) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002414) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085-002414) | |
| Enumeration Date | 2006-04-14 |
| Last Update Date | 2022-10-14 |