| NPI | 1629232780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.007781) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9104623) |
| 363A00000X Physician Assistant (Licence: FL 9104623) | |
| Enumeration Date | 2008-07-17 |
| Last Update Date | 2022-04-11 |