| NPI | 1285655647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9113613) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003542) |
| 363A00000X Physician Assistant (Licence: NY 0100009-1) | |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085003542) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2023-04-12 |