| NPI | 1528579901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006353) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.008918RX) |
| 363A00000X Physician Assistant (Licence: IL 085-006353) | |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2025-09-26 |