| NPI | 1649522574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.005490) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002699A) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2019-09-27 |