| NPI | 1750691671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-005095) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 268623) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2021-11-29 |