| NPI | 1609862275 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 4435) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 85000971) |
| Enumeration Date | 2005-09-20 |
| Last Update Date | 2017-02-10 |