| NPI | 1558761924 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.005044)  | 
| 363A00000X Physician Assistant (Licence: CA PA53686)  | |
| Enumeration Date | 2014-09-03 | 
| Last Update Date | 2023-05-22 |