| NPI | 1427514819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2025034969) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085006944) |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2025-10-15 |