| NPI | 1386984987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 8894812-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-004849) |
| Enumeration Date | 2013-02-20 |
| Last Update Date | 2024-06-25 |