| NPI | 1164194999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009189) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 4102) |
| Enumeration Date | 2021-09-30 |
| Last Update Date | 2022-12-14 |