| NPI | 1093927840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009558) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 011063) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2023-09-11 |