| NPI | 1801149752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4400) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.004491) |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2022-06-21 |