| NPI | 1942284195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: WI 1830) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-001150) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2015-05-04 |