| NPI | 1740277441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085003433) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 000104143) |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2013-03-22 |