| NPI | 1649578279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085-004668) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 23014665) |
| 363A00000X Physician Assistant (Licence: FL PA9106434) | |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2013-10-11 |