| NPI | 1689130775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2025008099) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 85007552) |
| Enumeration Date | 2019-02-14 |
| Last Update Date | 2025-07-08 |