| NPI | 1972872117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12034) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085004260) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2020-07-22 |