| NPI | 1013389451 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06032) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085011414) | 
| Enumeration Date | 2015-10-26 | 
| Last Update Date | 2025-10-02 |