| NPI | 1871745539 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 238.000090) | 
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: IL 238.000090) | 
| 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: IL 238000090) | |
| Enumeration Date | 2008-10-14 | 
| Last Update Date | 2018-10-04 |