| NPI | 1144941857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009234) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 5780-23) |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2023-05-24 |