| NPI | 1427515576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2025029775) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007007) |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2025-09-25 |