| NPI | 1659743979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005720) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002514B) |
| Enumeration Date | 2015-10-26 |
| Last Update Date | 2019-07-29 |