| NPI | 1699161976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 08-213) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2019-03-11 |