| NPI | 1376726281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12409) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003113) |
| Enumeration Date | 2007-12-13 |
| Last Update Date | 2018-03-17 |