| NPI | 1215775598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 85010779) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2024045398) |
| Enumeration Date | 2024-07-19 |
| Last Update Date | 2026-04-20 |