| NPI | 1801145602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004445) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3042) |
| Enumeration Date | 2012-09-07 |
| Last Update Date | 2023-08-17 |