| NPI | 1942546056 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085004589) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL 9106754) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2021-03-26 |