| NPI | 1932612140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 089093) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006421) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2020-04-07 |