| NPI | 1467541813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.003668) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA03596) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2012-04-13 |