| NPI | 1982378626 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008667) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: IL 085.008667) |
| Enumeration Date | 2021-08-05 |
| Last Update Date | 2025-04-15 |