| NPI | 1184071987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06782) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-008319) |
| Enumeration Date | 2016-05-21 |
| Last Update Date | 2025-04-22 |