| NPI | 1922480722 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006510) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 1125480) | 
| Enumeration Date | 2015-06-29 | 
| Last Update Date | 2025-10-18 |