| NPI | 1710201272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: MO 2011030386) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IL 085.003693) |
| 363A00000X Physician Assistant (Licence: IL 085.003693) | |
| 363A00000X Physician Assistant (Licence: MO 2011030386) | |
| Enumeration Date | 2010-03-26 |
| Last Update Date | 2014-01-31 |