| NPI | 1104443258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.008097) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5318-23) |
| Enumeration Date | 2020-07-05 |
| Last Update Date | 2025-06-09 |