| NPI | 1134899818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2022038139) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085008595) |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2023-09-13 |