| NPI | 1033474333 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9579) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015712) |
| 363A00000X Physician Assistant (Licence: IL 085007410) | |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2024-03-14 |