| NPI | 1679877328 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 007056) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003939) | 
| Enumeration Date | 2011-01-10 | 
| Last Update Date | 2014-09-16 |