| NPI | 1679956866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085.005473) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.393894) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2015-07-07 |