| NPI | 1386317824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085011735) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026902) |
| Enumeration Date | 2021-07-30 |
| Last Update Date | 2026-01-16 |