| NPI | 1033496930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085007424) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA PA21981) |
| 363A00000X Physician Assistant (Licence: WI 8281-23) | |
| Enumeration Date | 2011-11-07 |
| Last Update Date | 2025-04-22 |