| NPI | 1770112302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085007880) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007880) |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2026-03-23 |