| NPI | 1093267700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008232) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058759) |
| 363AS0400X Physician Assistant Surgical (Licence: NJ 25MP00414600) | |
| Enumeration Date | 2016-10-28 |
| Last Update Date | 2022-10-11 |