| NPI | 1841683133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2017009422) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085005412) |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2023-04-05 |