| NPI | 1013638352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 385.007538) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-09-06 |
| Last Update Date | 2023-12-05 |