| NPI | 1669646808 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006964) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2008013234) |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2019-03-11 |