| NPI | 1225144702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 024710) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003427) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-06-25 |