| NPI | 1497063291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2012042176) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003859) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2014-10-27 |