| NPI | 1457558371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085003882) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9110946) |
| 363A00000X Physician Assistant (Licence: FL PA9110946) | |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2024-07-17 |