| NPI | 1669891131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006055) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 51478) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2017-10-11 |