| NPI | 1013376201 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.008195)  | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10470)  | 
| Enumeration Date | 2016-02-16 | 
| Last Update Date | 2025-06-10 |