| NPI | 1366073645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007393) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 4976-23) |
| Enumeration Date | 2020-01-27 |
| Last Update Date | 2020-08-30 |