| NPI | 1255897989 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085006983) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 095209) |
| 363A00000X Physician Assistant (Licence: IL 085006983) | |
| 363A00000X Physician Assistant (Licence: NC 0010-12629) | |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2026-04-09 |