| NPI | 1659754323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005855) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3582-23) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2025-04-28 |