| NPI | 1730102468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: IL 1689434987) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085000331) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2025-12-06 |