| NPI | 1902095748 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085003002) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-003002) |
| 363A00000X Physician Assistant (Licence: MI 5601005288) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2024-09-18 |