| NPI | 1639792419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.007549) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 3557) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-07-23 |