| NPI | 1023762762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008823) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003600A) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2024-08-08 |