| NPI | 1336104934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-005152) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: VT 055-0030279) |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2025-08-11 |