| NPI | 1083195580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085010142) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4512-23) |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2024-04-04 |