| NPI | 1154724680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006536) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3438-23) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2024-01-19 |