| NPI | 1245565415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2009027331) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.005841) |
| 207P00000X Emergency Medicine (Licence: MO 2009027331) | |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2020-11-10 |