| NPI | 1770041949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085006956) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA100193) |
| Enumeration Date | 2019-03-06 |
| Last Update Date | 2023-12-13 |