| NPI | 1588190110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9110583) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007407) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2023-11-07 |