| NPI | 1720676919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-008104) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003107A) |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2025-07-30 |