| NPI | 1497056824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-003952) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085-003952) |
| 363AS0400X Physician Assistant, Surgical (Licence: WI 2708-023) | |
| 363AS0400X Physician Assistant, Surgical (Licence: IN 10001255A) | |
| Enumeration Date | 2010-11-17 |
| Last Update Date | 2014-06-26 |