| NPI | 1588229728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8194) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085008626) |
| 363AM0700X Physician Assistant, Medical (Licence: AZ 8194) | |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2024-03-25 |