| NPI | 1689627606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13040) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-001315) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2022-09-29 |