| NPI | 1073371993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.009412RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085010595) |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2025-08-14 |