| NPI | 1467933564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2021020597) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: IL 085006639) |
| Enumeration Date | 2018-08-27 |
| Last Update Date | 2023-12-01 |