| NPI | 1700823580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.006282) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA15382) |
| 363A00000X Physician Assistant (Licence: TN 2885) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2017-10-19 |