| NPI | 1669124087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008753) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003570A) |
| Enumeration Date | 2022-01-26 |
| Last Update Date | 2022-03-22 |