| NPI | 1558758466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9109395) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085.005429) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2016-09-19 |