| NPI | 1518184324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA LICSW1141708) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085002582) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2025-07-31 |