| NPI | 1144865601 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008587) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10002865A) |
| Enumeration Date | 2019-11-08 |
| Last Update Date | 2022-05-23 |