| NPI | 1730329715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005012) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-01743) |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2014-05-20 |