| NPI | 1720066418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-001173) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085001173) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085001173) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2020-09-14 |