| NPI | 1942082821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.010429) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363A00000X Physician Assistant (Licence: GA 12087) | |
| Enumeration Date | 2023-10-16 |
| Last Update Date | 2024-05-21 |