| NPI | 1982990271 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.006864) |
| 363A00000X Physician Assistant (Licence: MA PA4250) | |
| Enumeration Date | 2011-06-24 |
| Last Update Date | 2019-04-22 |