| NPI | 1295500189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023044681) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 85.010028) |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2025-08-20 |