| NPI | 1629481411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-005005) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 7893-23) |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2024-08-20 |