| NPI | 1639125883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2021049878) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005871) |
| 363A00000X Physician Assistant (Licence: MO 2010023051) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2022-10-05 |