| NPI | 1487922738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.001633) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 002253) |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2019-02-13 |