| NPI | 1760457352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085-002555) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2003029518) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2007-11-05 |