| NPI | 1952397945 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 002289) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085000311) |
| Enumeration Date | 2005-09-23 |
| Last Update Date | 2023-09-09 |