| NPI | 1255673919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IA 100785) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: IL 085004544) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2025-05-20 |