| NPI | 1801547120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085009660) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MP00678000) |
| Enumeration Date | 2022-01-18 |
| Last Update Date | 2024-01-30 |