| NPI | 1790118370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-004748) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002965A) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2020-10-14 |