| NPI | 1790021186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 51911) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004495) |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2015-06-04 |