| NPI | 1588835953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085003197) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 53424) |
| 363A00000X Physician Assistant (Licence: MO 2019004448) | |
| Enumeration Date | 2008-03-13 |
| Last Update Date | 2024-06-13 |