| NPI | 1013206747 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085006468) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY TC538) |
| 363A00000X Physician Assistant (Licence: KY PA2136) | |
| 363A00000X Physician Assistant (Licence: OH 50.003251) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2023-09-27 |