| NPI | 1487375077 |
|---|---|
| Former Name | GRACE COOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085010919) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10004607A) |
| Enumeration Date | 2022-09-12 |
| Last Update Date | 2024-11-01 |