| NPI | 1528764925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA101378) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085009508) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085009508) | |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2025-07-07 |