| NPI | 1457459281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2001003695) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 85002144) |
| 363A00000X Physician Assistant (Licence: MO 2000166686) | |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2008-02-08 |