| NPI | 1114418910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007454) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: FL PA9111278) |
| Enumeration Date | 2018-05-29 |
| Last Update Date | 2025-08-04 |