| NPI | 1720579063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008541) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2018016678) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2021-12-10 |