| NPI | 1427579432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9110443) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085008466) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085008466) | |
| Enumeration Date | 2017-06-29 |
| Last Update Date | 2025-06-16 |