| NPI | 1700260171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006184) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085006184) |
| 363AM0700X Physician Assistant, Medical (Licence: IN 10001860A) | |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2018-03-17 |