| NPI | 1912333675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085005795) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MI 5601006724) |
| Enumeration Date | 2013-09-25 |
| Last Update Date | 2021-12-08 |