| NPI | 1194370445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008038) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 4797-23) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 209007244) | |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2024-07-17 |