| NPI | 1831456755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085004318) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016743) |
| 363AS0400X Physician Assistant, Surgical (Licence: IL 085004318) | |
| Enumeration Date | 2012-04-17 |
| Last Update Date | 2023-03-24 |