| NPI | 1598099806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2010014127) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085003595) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2022-08-15 |