| NPI | 1942911953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085012264) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2026017186) |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2026-06-30 |