| NPI | 1619922481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085002149) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9104242) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2021-01-12 |