| NPI | 1215311881 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005545) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4675-23) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2023-12-20 |