| NPI | 1801838644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 0010-01546) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085001697) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2020-09-08 |