| NPI | 1538560818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005199) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA5770) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085005199) | |
| Enumeration Date | 2014-09-05 |
| Last Update Date | 2019-03-25 |