| NPI | 1225799216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2025026702) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085009603) |
| Enumeration Date | 2022-01-03 |
| Last Update Date | 2025-07-07 |