| NPI | 1386364636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.009122) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID 085.009122) |
| Enumeration Date | 2022-08-29 |
| Last Update Date | 2024-01-24 |