| NPI | 1669504270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 001786) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085002509) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2007-11-26 |