| NPI | 1952745903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2022013795) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NE 1774) |
| 363AM0700X Physician Assistant, Medical (Licence: IL 085004642) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2024-03-22 |