| NPI | 1952492829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085002906) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010044) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2013-07-30 |