| NPI | 1043374739 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 009614) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.007310RX) |
| 363A00000X Physician Assistant (Licence: MI 5601010832) | |
| 363A00000X Physician Assistant (Licence: IL 085.007620) | |
| 363A00000X Physician Assistant (Licence: IN 10003641A) | |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2022-08-22 |