| NPI | 1720742851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9118696) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: IL 085.008628) |
| 363AS0400X Physician Assistant, Surgical | |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085.008628) | |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2025-05-22 |