| NPI | 1700288990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085.005501) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA057179) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2022-07-21 |