| NPI | 1295932457 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01841) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 85002978) |
| 363AM0700X Physician Assistant, Medical (Licence: NC 0010-01841) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2016-12-07 |