| NPI | 1821392978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085010442) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CO PA.0006735) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA054617) | |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2024-07-01 |