| NPI | 1679212112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009581) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004315A) |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2026-05-12 |