| NPI | 1982772612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-00794) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002591) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2008-12-18 |