| NPI | 1932484946 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 3224) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 05004170) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2013-12-10 |