| NPI | 1770891756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085003861) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 62144) |
| 363A00000X Physician Assistant (Licence: NY 029213) | |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2023-12-28 |