| NPI | 1780102251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.006401) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2019-09-10 |