| NPI | 1336158831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 016545-1) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-002312) |
| 363A00000X Physician Assistant (Licence: IL 085002312) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2021-03-29 |