| NPI | 1639803828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 033737-01) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085010149) |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2025-07-28 |