| NPI | 1679947519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 023521) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005566) |
| Enumeration Date | 2015-11-16 |
| Last Update Date | 2019-11-05 |