| NPI | 1205464831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009722) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 100043) |
| 363A00000X Physician Assistant (Licence: NE 2476) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2023-11-20 |