| NPI | 1740793371 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085007899) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NJ 25MP00536800) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2021-02-08 |