| NPI | 1376856187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006675) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014073-1) |
| Enumeration Date | 2010-07-21 |
| Last Update Date | 2020-03-09 |