| NPI | 1548685787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5650) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-004989) |
| Enumeration Date | 2014-02-25 |
| Last Update Date | 2025-03-03 |