| NPI | 1700335817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9111899) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006004) |
| Enumeration Date | 2016-09-30 |
| Last Update Date | 2023-01-25 |