| NPI | 1548803562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 58584) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.007310) |
| Enumeration Date | 2019-10-22 |
| Last Update Date | 2025-02-06 |