| NPI | 1679241400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008989) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003401A) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2022-08-15 |