| NPI | 1619033446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01654) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002554) |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2009-05-05 |