| NPI | 1124593462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085-006755) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-15227) |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2025-11-13 |