| NPI | 1558862219 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.007266) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 021879) |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2023-06-15 |