| NPI | 1902378821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008719) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 12900) |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2025-04-15 |