| NPI | 1467904946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009004) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-06688) |
| 363A00000X Physician Assistant (Licence: NC 0010-06688) | |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2024-01-26 |