| NPI | 1700663994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 5774) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: IL 085.010687) | |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2024-10-15 |