| NPI | 1033747654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2021010568) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.008176) |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2024-11-12 |