| NPI | 1467881839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.004801) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001959A) |
| Enumeration Date | 2013-11-06 |
| Last Update Date | 2019-08-30 |