| NPI | 1720037823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085002950) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 9553) |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2021-12-30 |