| NPI | 1124509773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006538) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MO 2018034962) |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2025-08-27 |