| NPI | 1902121825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2010011164) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003719) |
| Enumeration Date | 2010-04-03 |
| Last Update Date | 2018-11-27 |