| NPI | 1487096483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.008345) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3171) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2023-09-07 |