| NPI | 1851099832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IL 085009823) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085009823) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2026-03-20 |