| NPI | 1548660871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2014030098) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005133) |
| Enumeration Date | 2014-08-22 |
| Last Update Date | 2022-09-07 |