| NPI | 1134612831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00476700) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007866) |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-04-26 |