| NPI | 1730466178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA156552) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004149) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2013-10-03 |