| NPI | 1174510200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085-001709) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004736A) |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2025-02-20 |