| NPI | 1689864738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 022072) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: IL 056007289) |
| 363A00000X Physician Assistant (Licence: CA PA21421) | |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085.003949) | |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2021-07-07 |