| NPI | 1568033660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009262) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: NC 0010-11342) | |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2023-05-03 |