| NPI | 1952812182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.006854) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 54803) |
| Enumeration Date | 2017-10-15 |
| Last Update Date | 2020-02-25 |