| NPI | 1225592264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.007783) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060282) |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2022-08-12 |