| NPI | 1558617910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004375) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07303) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085004375) | |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2025-07-28 |