| NPI | 1619546405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085012001) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601010530) |
| Enumeration Date | 2021-06-24 |
| Last Update Date | 2026-08-25 |