| NPI | 1518592203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085.007579) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MO 2020010184) |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2020-12-23 |