| NPI | 1225214380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2011008021) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL PENDING) |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2015-01-16 |