| NPI | 1538403548 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085006176) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9106939) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 017211-1) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2017-10-10 |