| NPI | 1699050781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2017-0087) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004195) |
| Enumeration Date | 2011-10-20 |
| Last Update Date | 2019-01-10 |