| NPI | 1689691289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-002053) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO DA109958) |
| 363A00000X Physician Assistant (Licence: MO 109958) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2011-11-29 |