| NPI | 1952599631 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2017017216) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003089) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2021-02-22 |