| NPI | 1780295022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PENDING) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.009693) |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2024-11-08 |