| NPI | 1457986366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.007595) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 026823) |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2021-07-30 |