| NPI | 1568659449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085003047) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001170A) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2019-09-27 |