| NPI | 1699144980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-12129) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085.005616) |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2023-05-05 |