| NPI | 1588072888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 0004613) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005080) |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2016-07-02 |