| NPI | 1609409184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 099904) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.007540) |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2020-02-29 |