| NPI | 1780853085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 2922) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085-003184) |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2009-11-03 |