| NPI | 1457854630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007178) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2018008862) |
| Enumeration Date | 2018-03-14 |
| Last Update Date | 2021-12-21 |