| NPI | 1740560507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004042) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10000503A) |
| Enumeration Date | 2011-08-25 |
| Last Update Date | 2011-08-25 |