| NPI | 1760822845 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004728) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3133-23) |
| Enumeration Date | 2013-07-03 |
| Last Update Date | 2025-06-25 |