| NPI | 1811081326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09283) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-001971) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2019-07-31 |