| NPI | 1366108169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.011377) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 5120) |
| Enumeration Date | 2021-11-16 |
| Last Update Date | 2025-08-18 |