| NPI | 1255924924 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 027470) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008182) |
| Enumeration Date | 2021-02-14 |
| Last Update Date | 2025-01-09 |