| NPI | 1821055088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.003061) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 1080) |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2022-04-01 |