| NPI | 1770890162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085003839) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10001491A) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2020-06-18 |