| NPI | 1508033218 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA052852) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 85-003727) |
| Enumeration Date | 2008-05-12 |
| Last Update Date | 2015-02-23 |