| NPI | 1568090769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2020007081) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085007387) |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2022-01-11 |