| NPI | 1992944904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085003419) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2009001275) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2010-07-21 |