| NPI | 1558347682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IL 085-004921) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: AK 1102) |
| Enumeration Date | 2005-12-20 |
| Last Update Date | 2014-05-21 |