| NPI | 1649728627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007354) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 020101) |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2024-12-10 |