| NPI | 1225621550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085011913) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: DE C5-0011584) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2026-04-08 |