| NPI | 1588917231 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006112) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 0160921) |
| Enumeration Date | 2012-10-18 |
| Last Update Date | 2018-03-17 |